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��n <br /> . <br /> PC Exhibit A <br /> � - RECEIVED <br /> C it�/ Of �r0 f1 O B 2� 20�2 <br /> Conditional Use Permit or FE <br /> C�T1l pF ORONO <br /> Other. Lan�d Use Permit Application <br /> � StreetAddress: Application# Z.— <br /> 2750 Kelley Parkway Date Received: L � � <br /> ��:�• Orono;MN 55356 <br /> 0 � � . , Staff: ' <br /> Main: 952-249-4600 <br /> fax: 952-249-4616 Fee: .�" d� d. Z Z � / O� <br /> � � Mailing Address: Escrow#&$ �' <br /> c5� P.O.Box 66 <br /> � p~ Crystal Bay,MN 55323-0066 Permit Fee $��� <br /> t`�'E880�'� Notes: <br /> , ,� �� <br /> This application form must be completed in full. Applicant will be notified within 15 days as to fhe status of the <br /> application. Incomplete ap�ications�I`not be placed on Pla ing Commission Agendas. <br /> Job Site Address: �v �� � a <br /> CONTRACTOR/APPLICANT INFORWIATION: �-� <br /> Name: �r p� i S��.00� � <br /> Phone: q_ Fax: SZ- �I - 39 <br /> Address: Cit : ��D ZIP: ,s <br /> Contact Person: �l e,C Contact's phone number - <br /> Email �',n„cc�.O�onO,, ���1(1�!/SApplicant is: Contractor Homeow (Circle One) <br /> PROPERTY OWNER INFORMATION: <br /> Name: drD�nco �•�b�i� Sc.�oo�S - <br /> Phone (day): Z- a C7 <br /> Mailing Address: � p1 ` C.r.��� a Q o+�0 /�( Z�P� S3S'�L <br /> Email and/or Fax q <br /> Overall.Project Description: `COn f✓vcfio � � ���o i ���.. v/ <br /> Check Box TYPE OF CONDITIONAL USE PERMIT Applicati Fee Escrow <br /> After-the-Fact Double <br /> Amend Existing CUP $700 N/A <br /> Commercial/Industrial Use $700* $700 <br /> Duplex Credit(per building) $700* $700 <br /> Grading and Filling-501 cu. d. or more $700*+permit Fee $700 <br /> Grading and filling—within 75' of OHWL(includes seawalls&retaining walls) $700*+Permit Fee $700 <br /> Grading and filling—wetland and floodplain $700*+Permit Fee $700 <br /> Guest House/Guest A artment $700* $700 <br /> Industrial(church,school,etc.) $700* $700 <br /> Renewal, IF no chan e to ori inal lan $350 NA <br /> Residential Accesso Structure $700" $700 <br /> Check Box OTHER LAND USE APPLICATIONS A lication Fee Escrow <br /> A peal of Administrative Decision $100 NA <br /> Commercial Site Plan Review $700* $10,000(minimum) <br /> Com rehensive Plan Amendment $700 NA <br /> Easement/Right-of-Wa ROW Vacation,with Subdivision $200" NA <br /> Easement/Ri ht-of Wa RO Vacation,without Subdivision $700* NA <br /> Rezoning $700 NA <br /> PID 5 acre minimum er code $200/acre minimum$1,000 $10,000(minimum) <br /> PUD Rezoning H 12 Corridor Onl —Residential $700+$40 er dwellin unit $10,000(minimum) <br /> PUD Rezonin H 12 Corridor Onl —Commercial/Industrial $200/acre minimum$875 $10,000(minimum) <br /> .,:,s-��, <br /> ''plus, Engineering�Legal Review Costs <br /> . x•.� . <br /> � CUP&Other Land,Use Applications . <br /> ' '.Updated: January'31,2012' ; <br /> ;,,;,,, * '; , - 13- . <br /> . . :t�Y ... '� <br />